This is not Chiari, but I Need Your Input/Help Please!!

[xmelax35]

I know a lot of you have disc and other issues as well, so I hope you might be able to help me from your experience, or maybe this might sound familiar to you.  Okay, I have been having very bad pain in my back and leg again (left side) but it moves to the right as well and my right leg kind of goes weak. Don't know why. I was in bad pain in PT and they had to stop it for now or indefinitely because I cried during the last few sessions. The Dr who did my surgery on my disc/ took the fragment out got me another MRI. He claimed that it would be understandable why I have it in the left side because of scar tissue. Then said nothing else to do!!!

I have an appt soon in PA to see the regular neurologist (it's a physicians assistant). Anyway, I got my MRI result.

On it, it says: L5-S1 There is left paracentral disc protrusion measuring 4mm in diameter that COMPRESSES THE LEFT S1 Nerve Root. in the lateral recess. There is associated enhancement along the margin of the disc.  There is no central spinal canal stenosis. There is mild bilateral foraminal narrowing.  Postsurgical changes are noted from a left L5 laminectomy. at this level where there is enhancement in the surgical bed as well as along the left side of the thecal sac and encasing left S1 and S2 Nerve Roots. There is also enhancement noted in the left erector spinae musculature.

Impression:
1. There is a left paracentral disc protrusion at L5-S1 that compresses the left S1 nerve root in the lateral recess.  
2. The Previously noted extruded disc fragment at L5-S1 inferiorly has been recected or resorbed. There is now enhancement noted within the L5 laminectomy bed as well as along the left side of the thecal sac, encasing the exiting left S1 and S2 nerve roots.

So what does all this mean??? In my mind I think sciatica. I also think what he said is true about the scar tissue. I don't know what else though. Is this causing me all this pain. Plus that it is herniated again, right? It doesn't help that I fell on the ice this week flat on my back!!! (this after my MRI).

I don't know what to do but I am in pain here.

[xmelax35]

I haven't had any activity on my post in the radiology forum yet. However, this is what has happened in the meantime. I did do what my family doc gave me advice on doing. I called and asked for the nurse. (I may not have done it exactly as I discussed with him, because of stuff she said...it threw me off). Anyway, I asked her if they got my actual MRI results that the Radiologist did. She said, well he says here he doesn't need to see you anymore, that there is scar tissue on the left side but it doesn't explain where the right side pain is coming from. I told her that I did have right side pain once in awihle as explained to them before, but it was probably the way I slept and it was probably just radiating pain. I said it was weird. Then I told her that I still have it on the left side as before and it is horrible, that it is the left side that it is mostly. I told them this before! They apparently ignored me. So then I let her know about my falls recently.  That can be another reason (I have fallen so much in the last few months - that could be why at the time I had right side pain). Then I told her that I am scared because the falls are because of my left leg just going like a noodle and giving out on me. So I wonder if he had the results and looked at them as well or if maybe when he personally looked at the CD if he missed something, because I am very concerned and scared.

She said if they got it, then it may have got thrown in a file somewhere and maybe it is now where they can find it.  She said that at the time they were busy and she would call me back that day, before the end of the day. I have not heard from them at all yet! I guess they have no plans on telling me what the results are.  I am not blaming them for what it says on there (they have no idea that I have the copy of them, only my regular doc does) and maybe they think that I am or they don't want to admit they are wrong in what they said to me and they don't want to give it to me straight now. I don't think that is right of them, if that is the case.

So, I decided to make an appointment for a 2nd opinion with another ortho neuro to look at my films. It is supposed to be for my lumbar, but I told them I want to bring my cervical ones as well, just in case they are willing to take a look at them too for me.

Well, I am very tired, I have been up all night long. That is another story.  I am going to try and go to sleep pretty soon, but my son has to be up soon, so i may have to try and stay awake a little longer.

[xmelax35]

I forgot about doing that. Thanks! That is helpful. I will go add that now. :)

[selmaS]

  No worries, I did take a look ....u may want to add what type of back surgery u had..it just says back surgery....I am sure the radiologist may be able to tell from the rest of the info....

But the rest looks very imformative

[xmelax35]

Oh I am sorry, I just meant my posting of how I said it. I didn't put a pic in, because I don't know how to do that yet. I was wondering if what I said sounded good. My brain *****. I haven't been feeling good at all for the last few months - mostly December. I mean obviously I never feel good (pain and symptoms) but in December I started getting more sick - a lot of throwing up and out of the blue. Not sure if it is pain related or what. It's not my pain meds, because I woke up one day and had to go get sick and it was like the exceroist. (however you spell it). :) It is like that alot lately. I lost about 8 or 9 pounds in the last month - I am sure from the getting sick.

[selmaS]

  I did not see a pic ....where is it?

[selmaS]

  I will look but will have to compare it to a normal  one of that area if I can locate one.

Not sure how I will do....as I am not use to doing this.....

[xmelax35]

I am going to look into it and call some places on Monday. I put my information in the Radiology forum in hopes that the Radiologist can give me some ideas about the enhancement in that area. My reg dr said it is a group of muscles and showed me where and he is concerned about it and thinks I should get it looked into right away. Hopefully the radiologist dr in the forum can give me some insight into it. If you get a chance, can you take a look and see if it looks good (not that I can take it off or anything and redo it), but what I posted...if it looks right. you know how we Chiarians can get all mixed up and bad concentration and stuff.

[selmaS]

  Yes, that is a big possibility....is there another surgeon u can get an opinion from?

[xmelax35]

My husband says that maybe he feels that since he did my surgery and this happened now, that he may think I am going to blame him for something and won't admit there is something wrong there. It could be very true, as that is what my Chiari Dr did.

[selmaS]

  No worries I followed it pretty well....lol....so glad ur PCP is on ur side and saw the report and knows u r in pain and feels the other Dr needs to see u again.

Hopefully they will consult and get u in and seen with open eyes this time.

[xmelax35]

Sorry about that last post above (I messed up on typing).

[xmelax35]

I just got back from my doctor.

He started to tell me he got a note from Dr. U. So I interupted him and said, yeh I want to talk to you about that. He did not give my mri  results and maybe he didn't see this but it says the disc is herniated again. I got my results because I will need them next month when I go to the neurologist. I told him I was going to Penn State (it is Penn State, but part of Penn State - not directly in Pitts). So I continued saying that it says the herniation is compressing on my sciatic nerve root. Then I told him it said something else I was unfamiliar with.  I showed him the results then. He sai I will need to go back to Dr U (even though he said he was done with me. That he will have to take care of it.  So he saw my results and knew darn well I was not lying about my pain, plus I fell flat on my back that day. He said he wasn't sure about what they meant by the enhancement of that one area, but hopefully Dr U will be able to find out. At least for now I have my family Dr on my side. He saw it for himself.

I said can I ask you for some advice. He said sure. I said I always clam up when it comes to asking questions and stuff to doctors esp when it comes to this kind of thing. I said How do I go about asking Dr. U about the MRI results I got. Then he gave me some advice and good advice. He said you have a right to know your results from the radiologist no matter what. He said I would want to know them if it were me. He said someone should tell you whether it is good or not.

Oh and by the way I got my shot in my head today, hopefully it will stop the pain from spreading for a few days. I have gone through the treximet already! I only get 6 a month until next month. I will google again that last part. It would be interesting to find out what that is. I wish the readiologist could specify more about it.

[selmaS]

  Wow, Iwas having issues rolling over too and getting out of bed, laying flat was the best thing for me...sitting or standing hurts like heck I am feeling better right now as long as I do not do too much, I am using a heating pad and  I lay down when  I need to.....

A NS will not help u with these other issues, even tho we still have pain as he feels it is not from the surgery or reason for surgery.....that goes for Chiari NS's.....my biggest pet peeve is no post op care.

As for ur google search on that last part...u could be right and may need an orthopedist....I know TCI has one, I was suppose to see one, but the one I was to see left b4 I could get in....not sure who they have now...but I had INS issues since and am waiting on the mail to see just what all I have and what Drs I can see....ugh....

[xmelax35]

Also does the enhancement noted in the left erector spinae musculature.sound like it could be spondylodiscitis? When I google searched that is what came up.

[xmelax35]

I just now thought of writing or typing out some of this stuff in question form and asking my regular doctor and then when he answers me honestly then I need to go ahead and give him that last page of my MRI. What do you think? I thought of doing something like, can you tell me what this means.... (kind of like a general question thing) and then if he says it is pain then I hand him my MRI. That way he can't change his mind and say oh well it won't cause you any pain. bull crap! It is on my sicatic nerve.

[xmelax35]

That is what i was told the last time by my doctor but this time he said no and looked at me like I was crazy. He literally said, "I am done with you, I never need to see you again". What!!! He was being a jerk! I only hope that he did not tell my regular doctor yet about his own findings - he looked at the MRI. That way I can ask my doctor about it. I thought I would just take the last page in with that information. If not I am going to be in this severe pain for awhile until I can find a dr who can help me. I have a feeling no more pain med today. I am out soon. I am sure if he believes the other dr he will not help me anymore. I have trouble getting out of bed (I am not talking depression) I mean actually sitting up. I have to have help or roll over to get up it is that bad from sleeping.

[selmaS]

  Impression is an over view and a more in depth look at what they feel is the cause for pain etc.....the findings many times can explain what all is going on, even mention things not in the impression, things that they may feel incidental....like Chiari, or low lying tonsils and sometimes tethered cord...this is y, it is important to read the whole thing and have a copy to do so....that way we know if the Dr is addressing all that is there.

I too am having back and leg weakness and pains....I think mine is EDS and tethered cord issues, I do have a bulging disk, but I am not sure that is my issue now.

I was also under the impression, nerves affected on the left would give pains on our right....????

[xmelax35]

p.s. what are the differences on an MRI between the Findings and The Impression? The findings seemed pretty normal (except some ddd) and the impression gave more information. Which is what they normally go by?